Value of dynamic MR imaging in assessing endometrial carcinoma involvement of the cervix

The purpose of this study was to evaluate endometrial carcinoma involvement of the cervix using dynamic MR imaging compared with T2-weighted and contrast-enhanced T1-weighted MR imaging.

In 42 patients with endometrial carcinoma, T2-weighted MR imaging using rapid acquisition with relaxation enhancement, dynamic MR imaging using gradient-echo sequences, and contrast-enhanced T1-weighted MR imaging using spin-echo sequences were performed before treatment. We evaluated patterns of enhancement in the cervix and tumor. In 39 of the 42 patients who underwent surgical treatment, we compared MR imaging findings with histologic results concerning cervical involvement.

Enhancement of the cervical epithelium was greater than that of the tumor and cervical stroma on dynamic MR imaging in most patients. In assessing cervical involvement, the accuracy of T2-weighted, dynamic, and contrast-enhanced T1-weighted MR imaging was 85%, 95%, and 90%, respectively; no statistically significant difference was observed. False-positive cases on T2-weighted MR imaging were correctly identified as having no cervical involvement on dynamic MR imaging using the finding of continuous enhancement of the cervical epithelium. We found this finding to be reliable in assessing tumor involvement of the cervix.

We believe that, in combination with T2-weighted MR imaging sequences, dynamic MR imaging is useful in assessing endometrial carcinoma involvement of the cervix.